Brianne J Herlitzke, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3554 Issued in WI

Practice address

1836 South Ave
La Crosse, WI 54601-5429

Phone

(608) 782-7300

NPI assigned

Apr 10, 2019

Last updated

Jun 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shoptikal LLC

  dba Shopko Optical 4002

  • Eyewear Supplier
  • Green Bay, WI
  • NPI 1659937159

  Optometrist

  Medicare reassignment Care Compare group NPD
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health Hamilton Clinic

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  Medicare reassignment NPD
• Shoptikal LLC

  dba Shopko Optical 4017

  • Eyewear Supplier
  • Saint Cloud, MN
  • NPI 1942866371

  Optometrist

  Medicare reassignment NPD
• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115
  Medicare reassignment
• Gundersen Clinic LTD

  dba Gundersen Pharmacy

  • Community/Retail Pharmacy
  • La Crosse, WI
  • NPI 1548710627
  NPD
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health La Crosse Hospital

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1376593442
  NPD
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health Onalaska Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD
• Shoptikal LLC

  dba Shopko Optical 4099

  • Eyewear Supplier
  • Onalaska, WI
  • NPI 1942866066

  Optometrist

  NPD
• Shoptikal LLC

  dba Fielmann Vision Care 4313

  • Eyewear Supplier
  • Rockford, IL
  • NPI 1467311142

  Optometrist

  NPD
• Shoptikal LLC

  dba Shopko Optical 4057

  • Eyewear Supplier
  • Winona, MN
  • NPI 1730745100

  Optometrist

  NPD
• Shoptikal LLC

  dba Shopko Optical 4066

  • Eyewear Supplier
  • Spokane, WA
  • NPI 1154987535

  Optometrist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1992268551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERLITZKE",
        "first_name": "BRIANNE",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ta Her, NP
• Deborah A Herczog, M.S.N., A.N.P.
• Ashley Herde, O.D.
• Michael William Herde, O.D.
• Roxanne M. Hericks
• Jesslyn Frances Herman
• Kimberly Herman, NP
• Beth A Hermes-Mitchell
• Kristine Herold
• Daniel Leighton Woodrow Heslop, MD

• Optometrist in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.